Background/Aims: Transarterial chemoembolization (TACE) is a widely applied standard treatment option for treatment-naïve patients with multifocal hepatocellular carcinoma (HCC). However, the treatment strategy in patients with multi-nodular recurrences has not been well addressed. This retrospective cohort study aimed to evaluate the efficacy of TACE for recurrent HCC. Methodology: Two hundred seventeen consecutive patients who received curative ablation therapy for HCC were followed up. Forty-three of the 217 underwent TACE for recurrent HCC, and the treatment efficacy after TACE was compared with that in 99 treatment-naïve patients who underwent TACE for multifocal HCC during the same period. Results: The overall survival rates of the patients after TACE for recurrent HCC were not different (P=0.136) from those of thetreatment-naïve patients after TACE. No serious adverse events related to TACE were observed in either group. Serum albumin levels (>3.5g/dL, p=0.001), alpha-fetoprotein levels (<300ng/mL, p=0.021),protein induced by vitamin K absence or antagonist II levels (<300ng/mL, p=0.045), and the number of recurrent tumors (≤3 nodules, p=0.047) were prognostic factors after TACE in patients with recurrent HCC. Conclusions: TACE for multifocal recurrent HCC is safe and effective, with good survival results, similar to those of initial TACE for treatment-naïve patients with multifocal HCC.